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It took four interviews for Michael, 27, to clinch a position at one of the city's most prestigious advertising firms, including the interview where a senior vice-president shuffled papers for fifteen minutes while Michael stared and finally pointed to his pencil holder and barked, "Sell me this!"

The position meant more money and the chance to work with top creative people on prime accounts. Michael expected to feel ecstatic, but after a week or two he realized nothing had changed. "There's this sense of gloom I can't shake. I just feel flat. I recently bought a condominium, but I find myself wandering around in it, wondering, "Why do I feel so empty?"

If you can identify with the type of lingering emptiness Michael feels ask yourself: Do you lack energy? Is it hard to find anything you're interested in? Do you feel vaguely unhappy, without any real reason? Do you put yourself down all of the time? Are you sleeping too much, or having trouble falling asleep at all? Is it hard to concentrate? To make decisions?

If you answer yes, like Michael and an estimated eight million other Americans you may be suffering from a condition known as dysthymia, a chronic low-grade depression.

What causes dysthymia? Some researchers believe all depressions are biologically based and possibly caused by a deficiency of neurotransmitters or brain hormones such as serotonin. This research led to the popularity of such antidepressant medications as Prozac, which balance the supply of naturally produced neurotransmitters

Others believe dysthymia results from a psychological imbalance in thinking--distortions in the way we perceive the events in our lives which lead to habitual negative thoughts.

The root of dysthymia may well be a combination of both factors. In any case, the number of cases is growing in what some experts feel are epidemic proportions. It is becoming more prevalent because of the current social climate--corporate turmoil, a flat economy, climbing rates of divorce, and strains from changing sex roles.

The tragedy is, only one out of five victims of dysthymia or other types of depression ever seeks help. As one woman tells it, "I went to work, I functioned, I just never got very much pleasure out of anything. But I'd felt that way for so long I thought, this is just me, the way I am. When I heard about dysthymia and finally found the right treatment, it was like a cloud was lifted."

Because the sufferer may not have any seriously debilitating symptoms, he or she may cringe at the idea of therapy or even medication for what seems a simple lack of get up and go. Many dysthymics try to adapt to the depression, and it is these adaptations that sometimes catapult the person into treatment: "I was drinking a glass or two of wine, never before six, to cope with the stress of working all day, and then having a second shift at home," admits Karla, thirty-two, a real-estate agent. "Then it became three or four glasses and it was starting to get scary. I've learned there are more effective ways to deal with depression in the 90s than with a glass of Chardonnay."

For many people, chronic low grade depression is a retreat from feelings such as anger, hurt or sadness. Scott, a freelance graphic designer, found himself unable to make the calls or build the connections he needed the first year he attempted to begin his own business. When he'd think of creative ways to promote his services, a voice inside of him would say, "What's the use? What do I really know, anyway?" Sluggish and confused, he retreated into shuffling paperwork, or over servicing the few clients he did have, too weary to move in new directions.
"In therapy I learned that I saw everything in black and white--I was either a total success or a miserable failure. I was such a perfectionist that doing the simplest thing was exhausting. My depression was about resistance." With support, Scott learned new skills for looking at each day, each incident, more realistically and not generalizing everything.
What can you do if you suspect you're suffering from chronic low-grade depression? Consider the following:

Do you feel you're depressed because you have an unsatisfying career, or a troubled relationship? It's just as likely that you have a difficult career or unhappy relationship because you're depressed.

You are not at fault. It can happen to anyone. This idea that we should be able to pull ourselves up by the boot straps keeps more people stuck than any single factor. Such thoughts aren't necessarily signs of strength. Often such a mind set springs from compulsive self-reliance caused by a damaged ability to trust.

You may simply call what you feel burnout, or a bad mood and it may be. But, it's difficult to assess the level of depression when you're in it. In our practice we've often seen a simple evaluation dispel fears and bring people a new sense of hope. An objective person can help you confront the underlying questions: Are certain events in your life making you unhappy? Or is the problem your distorted, inner reaction to them, which is something that you can change with some new skills? Could you be suffering from a biochemical imbalance that hasn't been diagnosed?

With the right kind of treatment, nearly everyone can experience relief from dysthymia, often in a matter of twelve to fourteen weeks. You have a right to enjoy your own life, to feel alive, to have a vision and the energy to go after it.